When I went in for my 16 week appointment, my doctor asked if my dates could be off. I told her there was no way, I was absolutely certain of our dates. She asked me to come back later that week to get an ultrasound. I had a suspicion of what she was thinking, and suggested "how about if I come back later today for the ultrasound?" The idea of waiting and wondering for several days did not sound fun. Thankfully, they scheduled me to come back in that afternoon. I called my husband, Dan, and told him I needed to have an ultrasound to "check my dates.” I tried to make it sound like it was no big deal so as not to alarm him. I was really trying to convince myself that this was no big deal. Dan caught me off guard when he said he was going to leave work and would be there in a little bit for the ultrasound. Noah and I went back to the doctor’s that afternoon for the ultrasound. After getting situated on the table, the ultrasound tech said, "There's the heart beating...and there's another one." I was speechless. Was this really happening? Talk about a surreal moment. Two babies?! There was a knock on the door. It was Dan. I was in shock, so I asked the tech to tell him. She showed him the heart beating and then the other one as well. Dan’s jaw dropped.
During the next 4 weeks, we shared the news with family and friends, while I tried to process the news for myself. The idea of twins had always scared me. I didn’t think I could handle it. Twins sounded overwhelming. I am a person who enjoys quiet, peace, order, organization and control. You know the kind. I like my towels all folded in the same direction, the dishwasher loaded a certain way, my closet organized by length of sleeve and color all on white hangers. I knew my world was about to be turned upside down. I was going to have to let go of striving for a neat, organized house. Little did I know, just how much stretching God had in store for me. A season of growing and trusting was on the horizon. It took a LOT of soaking in.
With our first pregnancy, we did not want to know if we were having a boy or a girl because I love surprises. We decided to wait. I thought of it like, not wanting to open a Christmas present until Christmas morning. However, after finding out we were going to have twins, we decided that was enough of a surprise and now we wanted to know their gender. So at my regular 20 week ultrasound appointment, we found out we were having 2 girls! My OB proceeded to tell us we needed to go to see a specialist, a perinatologist, because there were some concerns about their size discrepancies.
Off we went to meet with the perinatologist. As the doctor sat so seriously behind his desk, he told us our babies had Twin to Twin Transfusion Syndrome (TTTS), a rare syndrome that occurs in less than 0.1-0.9 in 1,000 births. The prognosis was poor since it presented itself so early in the pregnancy. The doctors were going to do their best but admitted that there is still so much to TTTS that they do not understand. I was to go on bedrest from here on out and they would monitor the girls weekly. The appointment was somber. I went from feelings of shock, to begging God to save both of our little girls.
|These photos are of Baby A. Baby B always hid from the camera.|
|Noah named our girls Peek and Boo.|
I wondered how on earth I was going to be able to handle laying on the couch all day every day (minus doctor appointments). As a mom of a toddler boy, I was used to running around all day. Somehow just knowing that it was "my job" to keep my 20 week old girls safe helped me to stay down, even despite the aching bursitis in my hips. The health and safety of our little girls was completely out of my control but this was the one thing I could do to help them. Noah, who was always quite independent, quickly became a snuggler and wanted to do his activities near Mom. It's amazing how little ones can sense when something is wrong. We spent a lot of time together by the couch coloring, reading books, doing puzzles, listening to music and watching movies.
Our babies had their own amniotic sacs but shared one placenta. Their blood vessels in the placenta were connected, transfusing fluids between the two babies, unequally. Baby "A" was referred to as the recipient twin because she had too much fluid in her sac, which caused pressure on her heart. Baby "B" was referred to as the donor twin, she had very little fluid in her sac, thus had difficulty growing. The earlier you develop TTTS in your pregnancy, the worse your chances of survival or healthy babies. Getting diagnosed at 20 weeks is considered early and made their odds of survival slim.
After getting diagnosed, I hit the computer hard. Researching as much as I could about TTTS. I had heard of it before and seen babies diagnosed late in pregnancy, while I worked as an RN, in a Special Care Nursery. The mama nurse in me was on a mission to understand TTTS the best I could. Many family and friends brought meals over including my sweet co-workers who faithfully brought meals twice a week and would often stay to visit. Their faithfulness, endurance and thoughtfulness showed me the love of my heavenly father in such a tangible way. Noah was always eager to greet them at the door, with guitar in hand and sing them some of his favorite songs like, "Indescribable" by Chris Tomlin or "Marvelous Light" by Charlie Hall. I'll never forget him standing by the door, strumming his guitar that was as big as he was and singing such big words, with no reservations.
When I found out I was pregnant with Noah, our first pregnancy, I was really fearful of a miscarriage. But God impressed on me how much He loved my baby, even more than I ever could. This baby was ultimately His. That my husband and I get to care for and love God's precious child for whatever amount of time He gives us. Even if we never get to see his or her sweet face. We never know how long we will have with our children. But we can trust in God's good and perfect love for them. This truth during Noah's pregnancy was preparing me for this season.
Appointments went from a couple times a week, to daily ultrasounds and then weekly echocardiograms with the pediatric cardiologist to monitor Baby A's heart. With each appointment we went in for, we didn't know if our babies would still be alive.
God poured out his love and peace to me with timely verses about how he never changes. He is the great I am. He is the same God who led Moses and the Israelites across the parted sea on dry land. He is the same God who protected Daniel from the mouths of lions. He is the same God who instructed Noah to build an ark even when rain had never fallen from the sky before. He is the same God that fufilled his promise to Abraham and gave him a son, even though it seemed impossible due to their old age. He is the same God who sent His only son to rescue us by coming into our sinful world to fulfill the Old Testament scriptures. He was born of the virgin, Mary and to be called Immanuel, which means "God with us." He suffered great pain for us and our sins. He died on a cross and rose 3 days later. He is that same God today, in this moment, and in tomorrow with whatever may come. He will never leave us. He is always with us.
At 26 weeks, we had our second amnio reduction done. During an amnio reduction, the doctor goes into the amniotic sac with a long needle to remove the excess fluid. Removing the fluid is an attempt to control the excess fluid in Baby A's sac which would hopefully help relieve some of the pressure on her heart. Baby A was showing tricuspid regurgitation, a beginning sign of heart failure. Baby B was showing some absent end diastolic flow, where the blood flow through her umbilical cord would basically stop coming to her. Unfortunately, the fluid removal during the amnio reduction did not help enough. Our doctor referred us, out of state, to one of four fetal surgeons in the US, to look into a surgical treatment option.
It was the Sunday before Thanksgiving, I was 26 weeks pregnant and Dan and I were getting on a flight to meet with a Fetal Surgeon and his team. I usually love flying and staying in hotels, but this was not a trip to look forward to.
The next morning, we were greeted by a wonderful nurse, who helped us walk through our full day of tests. At the end of the day, we met with the Fetal Surgeon, Neonatologist, Pediatric Cardiologist, Radiologist and several more team members in a conference room where they presented to us the results of what was happening to our little girls. They explained that TTTS is categorized into stages 1, 2, 3A, 3B, 3C and 4. The fourth stage was the demise of either baby. Our girls were in stage 3A. The option was to do Fetal Laser Surgery to basically disconnect the blood vessels in the placenta that were connected to each other, thus stopping the TTTS. However, because I was 26 weeks along, they would not be able to perform the surgery if we waited any longer. If we proceeded, there was only a 50/50 chance that both girls would survive. The laid it all on the table then told us the decision was ours to make. So there we were faced with the hardest decision of our lives and we had to decide then and there.
After asking a few more questions, to make sure we understood everything the best we could, we decided to not do the surgery. We would continue the pregnancy with close monitoring including ultrasounds each day, echocardiograms weekly and aggressive amnio reductions as needed and leaving our girl’s future in our loving, powerful God’s hands. We hoped for being able to make it another 2 to 4 weeks before delivery.
We flew home from Cincinnati, celebrated Thanksgiving, still on bedrest, then I was admitted to the hospital on bedrest to keep a really close eye on our babies. I was surprised at just how difficult it was to be hospitalized, on bedrest. I got so sad being away from my family. I felt like I wasn't able to a a Mom to my little boy and missed him so much, plus it was Christmas time. Thankfully, after a couple of weeks, my doctor decided I could go home. My Dad came back to town and was willing to drive me to my appointments every day while I promised to stay on strict bedrest. It did my heart such good to be home again.
As a little girl Psalm 23 seemed so mysterious, I suppose I read it quite literally as a child. I was listening to a Beth Moore teaching on this verse, called The Lord is My Shepherd, and finally deeply understood the meaning. Here we were walking through our own valley of the shadow of death.
He was with us. He is with you too. Trust in His deep, deep love for you. Trust in His goodness despite your current circumstance.
At 31 4/7 weeks, the cardiologist recommended our babies be delivered. The recipient’s heart wall was continuing to thicken. Delivery day was scheduled for 32 weeks. We were excited, grateful to have gotten so far along, and nervous to meet our little girls, not knowing what would lay ahead of them in the Neonatal ICU (NICU).
Here is a portion of an email my husband sent out. Dan wrote, "At 8:30 we said hello to Anna Hope and at 8:31 we said hello to Josephina (Josie) Faith. Anna weighs 4lbs 5oz and Josie weighs 3lbs. Melanie is doing well. Today I asked our Dr. now that we are all done with the TTTS situation, what was He thinking when he saw us at 20 weeks. He responded almost immediately, I thought you'd lose one of them, if not both. At the c-section the Dr. brought me over and showed me the placenta. She could see that Anna had maybe 75% of the placenta and Josie had 25%. She said that Josie didn't have enough of the placenta to support herself and if they didn't have TTTS Josie would have died. So what we have thought was the problem ended up being the life saver. "For the winter is past, and the rain is over and gone. The flowers are springing up and the time of singing birds has come.” -Song of Songs 2:11-12
With that news, we were in awe at the Sovereignty of God!
"For you created my inmost being; you knit me together in my mother's womb, I praise you because I am fearfully and wonderfully made; your works are wonderful, I know that full well. My frame was not hidden from you when I was made in the secret place. When I was woven together in the depths of the earth, your eyes saw my unformed body. All the days ordained for me were written in your book before one of them came to be. How precious to me are your thoughts, O God! How vast is the sum of them!” -Psalms 139:13-17
We thought the hard times were behind us, except life in the NICU doesn’t always work that way. They were preemies and still had tough days ahead...